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ASCO 2025 | The future of hippocampal avoidance in treating brain metastases

Anca-Ligia Grosu, MD, University of Freiburg, Freiburg, Germany, emphasizes the need for randomized studies to compare hippocampus sparing with dose escalation versus radiosurgery in treating brain metastases. In clinical practice, hippocampus sparing techniques may be considered in specific patient populations, such as those with lesions near meningeal areas or post-surgical patients at risk of accelerated brain disease. This interview took place during the 2025 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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Transcript

So I think that we need studies, randomized studies, and we have, actually we have no results, but some studies are ongoing. We need to have randomized studies in which we compare this technique, hippocampus sparing and dose escalation versus radiosurgery technique. And I think only using the information from these studies, we will be able to make a differentiation in which patients we have to use radiosurgery, in which patients we have to use the whole brain irradiation with hippocampus avoidance...

So I think that we need studies, randomized studies, and we have, actually we have no results, but some studies are ongoing. We need to have randomized studies in which we compare this technique, hippocampus sparing and dose escalation versus radiosurgery technique. And I think only using the information from these studies, we will be able to make a differentiation in which patients we have to use radiosurgery, in which patients we have to use the whole brain irradiation with hippocampus avoidance. However, in clinical practice, maybe in patients with lesions located very close to the meningeal areas with possible development of leptomeningeal disease, this could be an indication. Patients after surgery could be an indication. So patients in which we think that the brain disease will accelerate in the next months and we want to stop this development.

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